Basic Information
| Provider Information | |||||||||
| NPI: | 1982802690 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CALIFORNIA HEART AND LUNG SURGERY MEDICAL CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6253 HOLLYWOOD BLVD APT 1108 | ||||||||
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| City: | HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900288261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495882190 | ||||||||
| FaxNumber: | 9495882199 | ||||||||
| Practice Location | |||||||||
| Address1: | 269 S BEVERLY DR | ||||||||
| Address2: | #444 | ||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902123807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495882190 | ||||||||
| FaxNumber: | 9495882199 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2007 | ||||||||
| LastUpdateDate: | 12/04/2018 | ||||||||
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| AuthorizedOfficialLastName: | MARMUREANU | ||||||||
| AuthorizedOfficialFirstName: | ALEXANDER | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9495882190 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | A72254 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.